Document Type : Original Article
Authors
1 Department of Midwifery and Reproductive Health, Nursing and Midwifery Care Research Center, Faculty of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
2 Department of Psychology and Education of Children with Special Needs, University of Isfahan, Isfahan, Iran,
3 Department of Social Sciences, Bu-Ali Sina University, Hamedan, Iran, Department of Sociology and Anthropology, Nipissing University, Ontario, Canada
Abstract
INTRODUCTION: Childbearing is an important event in a couple’s life. The parents might have children
with disability that affected on their well‑being after the children’s birth. Well‑being considered as an
important aspect of a couple’s quality of life which may alter the future of their fertility. The present
study was conducted to the association of psychological well‑being and fertility intention in parents
with educable intellectually disabled children.
METHODS: The study was a cross‑sectional descriptive research conducted on parents of children
with intellectual disability (n = 386). Parents were selected randomly of schools of exceptional
education and welfare. The data were collected using Ryff’s scale of psychological well‑being,
demographic information, and fertility intention questionnaire. Data were analyzed using descriptive
and analytical tests including independent t‑test, Chi‑square test, Mann–Whitney U‑test, and Logistic
regression.
RESULTS: The majority of parents (83.9%) reported the negative infertility intention. Despite the mean
score of well‑being in parents without fertility intention (75.71 ± 11.67) was lower than parents with
fertility intention (76.90 ± 11.27), the difference was not statistically significant (P > 0.05). The logistic
regression analysis indicated that the parents’ age and number of children with intellectual disability
were predictors of fertility intention (P < 0.05), and their increase decreased the fertility intention.
CONCLUSION: It seems that the lack of difference in psychological well‑being scores between the
two groups of parents might be due to the equal severity of disability in children. The results also
indicated parents’ age and the number of children correlated with fertility intention. The findings can
be used to advance counseling programs in the field of healthy reproduction for this group of parents.
Keywords
- Moeeni M, Pourreza A, Torabi F, Heydari H, Mahmoudi M.
Analysis of economic determinants of fertility in Iran: A multilevel
approach. Int J Health Policy Manag 2014;3:135‑44.
2. Grant J, Hoorens S, Sivadasan S, Loo MV, Davanzo J, Hale L,
et al. Trends in European fertility: Should Europe try to increase
its fertility rate.or just manage the consequences? Int J Androl
2006;29:17‑24.
3. Kariman N, Amerian M, Jannati P, Salmani F, Hamzekhani M.
A path analysis of factors influencing the first childbearing
decision‑making in women in Shahroud in 2014. Glob J Health
Sci 2016;8:55381.
4. PriskornL, HolmboeSA, Jørgensen N, AnderssonAM, AlmstrupK,
Toppari J, et al. Adverse trends in male reproductive health and
decreasing fertility rates. Anim Reprod Sci 2012;9:760‑71.
5. Pobric A, Robinson GM. Population ageing and low fertility:
Recent demographic changes in Bosnia and Herzegovina.
J Population Res 2015;32:23‑43.
6. Hosseini‑Chavoshi M, Abbasi‑Shavazi MJ, McDonald P. Fertility,
marriage, and family planning in Iran: Implications for future
policy. Population Horizons 2016;13:31‑40.
7. Erfani A. Policy implications of cultural shifts and enduring low
fertility in Iran. Community Health 2019;6:112‑5.
8. Xiang Y, Chi X, Wu H, Zeng T, Chao X, Zhang P, et al. The trauma
of birth or parenting a child: Effect on parents’ negative emotion
in China. Arch Psychiatr Nurs 2017;31:211‑6.
9. Mencarini L, Vignoli D, Gottard A. Fertility intentions and
outcomes: Implementing the theory of planned behavior with
graphical models. Adv Life Course Res 2015;23:14‑28.
10. Testa MR. On the positive correlation between education and
fertility intentions in Europe: Individual‑ and country‑level
evidence. Adv Life Course Res 2014;21:28‑42.
11. Doss BD, Rhoades GK, Stanley SM, Markman HJ. The effect of
the transition to parenthood on relationship quality: An 8‑year
prospective study. J Pers Soc Psychol 2009;96:601‑19.
12. Allendorf K, Ghimire DJ. Determinants of marital quality in an
arranged marriage society. Soc Sci Res 2013;42:59‑70.
13. Sefidi F, Farzad V. Validated measure of Ryff psychological
well‑being among students of Qazvin University of Medical
Sciences (2009). J Qazvin Univer Med Sci 2012;16:65‑71.
14. Kazemi N, Dadashloo F, Seyf FS. Prediction of psychological
well–being and resilience in mothers of children with autism
spectrum disorder based on cognitive flexibility. Middle Eastern
J Disabil Studi 2019;7:177‑89.
15. Sadooghi M. Explanation of psychological well‑being based on
positive psychology components. Rooyesh e Ravanshenasi J
2018;7:177‑98.
16. Margolis R, Myrskylä M. Parental well‑being surrounding first
birth as a determinant of further parity progression. Demography
2015;52:1147‑66.
17. Matsuo H, Matthijs K. The impact of well‑being on fertility
intentions – An analysis based on the European Social
Survey (2010). Ask 2016;25:17‑46.
18. Abbasi M, PiraniZ. Pathological defense mechanisms of parents of
deaf children and children with intellectual disabilities: A search
for corrective solutions. Middle Eastern J Disabil Stud 2017;7:1‑7.
19. Schalock RL, Luckasson R. What’s at stake in the lives of people
with intellectual disability? Part I: The power of naming, defining,
diagnosing, classifying, and planning supports. Intellect Dev
Disabil 2013;51:86‑93.
20. Maulik PK, Mascarenhas MN, Mathers CD, Dua T, Saxena S.
Prevalence of intellectual disability: A meta‑analysis of
population‑based studies. Res Dev Disabil 2011;32:419‑36.
21. Findler L, Klein Jacoby A, Gabis L. Subjective happiness among
mothers of children with disabilities: The role of stress, attachment,
guilt and social support. Res Dev Disabil 2016;55:44‑54.
22. Crnic KA, Neece CL, McIntyre LL, BlacherJ, Baker BL. Intellectual
disability and developmental risk: Promoting intervention to
improve child and family well‑being. Child Dev 2017;88:436‑45.
23. Kayama M, Haight W. Disabilityand stigma: How Japanese
educators help parents accept their children’s difference. Soc
Work 2014;59:24‑33.
24. Macinnes MD. One’s enough for now: Children, disability,
and the subsequent childbearing of mothers. J Marriage Fam
2008;70:758‑71.
25. Wehby GL, Hockenberry JM. Impact of child health and disability
on subsequent maternal fertility. Rev Econom Household
2017;15:995‑1016.
26. Modena F, Rondinelli C, Sabatini F. Economic insecurity
and fertility intentions: The case of Italy. Rev Income Wealth
2014;60:S233‑55.
27. Azmoude E, Behnam H, Barati‑Far S, Kabirian M. The relationship
of socio‑demographic factors, fertility behavior and child’s
perceived value with fertility intention of women in a region
in the East of Iran. Int J Community Based Nurs Midwifery
2017;5:123‑33.
28. Caplescua R. Using the theory of planned behaviour to study
fertility intentions in Romania. Procedia Econom Finance
2014;10:125‑33.
29. Erfani A. Low fertility intention in Tehran, Iran: The role of
attitudes, norms and perceived behavioural controle. J Biosoc Sci
2017;49:292‑308.
30. Khorram R, Hasani M, Karimy M, Mohammadi A, Ranjbaran M.
Factors related to women’s fertility intent: A study based on the
theory of rational action. J Holist Nurs Midwifery 2017;27:57‑66.
31. Heiland F, Prskawetz A, Sanderson WC. Are individuals’ desired
family sizes stable? Evidence from West German panel data. Eur
J Popul 2008;24:129.
32. Rabbi AM. Factors influencing fertility preference of a developing
country during demographic transition: Evidence from
Bangladesh. South East Asia J Public Health 2014;4:23‑30.
33. Babalola S, Oyenubi O, Speizer IS, Cobb L, Akiode A, Odeku M.
Factors affecting the achievement of fertility intentions in urban
Nigeria: Analysis of longitudinal data. BMC Public Health
2017;17:942.
34. Park JM, Hogan DP, Goldscheider FK. Child Disability and
Mothers’ Tubal Sterilization. Perspect Sex Reprod Health
2003;35:138‑43. - 35. Hauser RM, Springer KW, Pudrovska T. Temporal structures of
psychological well‑being: Continuity or change. Meetings of the
Gerontological Society of America, Orlando, Florida; 2005. p. 30‑1.
36. Billingsley S, Ferrarini T. Family policy and fertility intentions in
21 European countries. J Marriage Fam 2014;76:428‑45.
37. Abbasi S, Sajedi F, Hemmati S, Najafi Fard T, Azadchehr MJ,
Poursadoghi A. Evaluation of quality of life in mothers of children
with Down syndrome. Pract Clin Psychol 2016;4:81‑8.
38. MugnoD, Ruta L, D’Arrigo VG, Mazzone L. Impairment of quality
of life in parents of children and adolescents with pervasive
developmental disorder. Health Qual Life Outcomes 2007;5:22.
39. Bulto GA, Zewdie TA, Beyen TK. Demand for long acting and
permanent contraceptive methods and associated factors among
married women of reproductive age group in Debre Markos
Town, North West Ethiopia. BMC Womens Health 2014;14:46.
40. Dibaba Y. Factors influencing women’s intention to limit child
bearing in Oromia, Ethiopia. Ethiop J Health Dev 2009;23:33‑28.
41. Newacheck PW, Strickland B, Shonkoff JP, Perrin JM,
McPherson M, McManus M, et al. An epidemiologic profile of
children with special health care needs. Pediatrics 1998;102:117‑23.
42. Bandehelahi K, Khoshravesh S, Barati M, Tapak L. Psychological
and sociodemographic predictors of fertility intention among
childbearing‑aged women in Hamadan, West of Iran: An
Application of the BASNEF Model. Korean J Fam Med
2019;40:182‑7.
43. Bhargava A. Desired family size, family planning and fertility in
Ethiopia. J Biosoc Sci 2007;39:367‑81.
44. Dadkhah A, Tabrizi RG, Hemmati S. Quality of life of disabled
children’s mother: A comparative study. Iran Rehabil J 2009;7:36‑8.
45. Duvdevany I, Abboud S. Stress, social support and well‑being
of Arab mothers of children with intellectual disability who are
served by welfare services in Northern Israel. J Intellect Disabil
Res 2003;47:264‑72.
46. Abasi S, Fadakar K, Khaleghdoost T, Sedighi A, Roshan ZA.
Survey the problems of families with mentally retarded child
covered by Guilan Welfare Centers in2010. J Holistic Nurs
Midwifery 2010;20:33‑9.
47. Zheng Y, Yuan J, Xu T, Chen M, Liang H, Connor D, et al.
Socioeconomic status and fertility intentions among Chinese
women with one child. Hum Fertil (Camb) 2016;19:43‑7.
48. Durmaz A, Cankaya T, Durmaz B, Vahabi A, Gunduz C,
Cogulu O, et al. Interview with parents of children with Down
syndrome: Their perceptions and feelings. Indian J Pediatr
2011;78:698‑702.
49. Rogers M, Hogan D. Family life with children with disabilities:
The key role of rehabilitation. J Marriage Fam 2003;65:818‑33.
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